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ICD-10 Preparation Updates

Update #1 - May 26, 2015

Your Transition to ICD-10


To our valued partners,

As you are aware, the transition to ICD-10 is rapidly approaching. To help you prepare for that transition and navigate some of the complexities involved, we will be sending out a series of updates regarding steps you should be taking as well as any other information we feel you should to be aware of.

The first step is to ensure your hardware and software platforms meet the requirements for HIPAA HITECH advanced security. These are also the same requirements for the next version of our software which incorporates ICD-10. Those system requirements are attached for your review.
 

  • Review your current census and ensure all patients have a current diagnosis in the Diagnosis History tab.
  • Familiarize yourself with the ICD-10 codes you will need.
     

We recommend the following links on the CMS.gov website to research this transition further.

 

ICD-10 Basics:

These basic resources include overviews of ICD-10 tailored by audience. All resources are also available through the CMS ICD-10 website, cms.gov/ICD10:

More detailed resources can be found at

 

We're here to answer any questions you might have and to help you get your facility ready for the October countdown. Stay tuned for further updates!

 

 

Update - June 16, 2015

 

ICD-10

In the second of our series of updates, we wanted to give you an update on our progress as well as give you an idea where you should be in the process.

In Preparation

You should be:

  • Reviewing your current census and ensure all patients have a current/active/primary diagnosis in the Diagnosis History tab.
     
  • Finalizing an internal strategy for converting from ICD-9 to ICD-10 as well as how your clinical and billing teams will to work together to establish a workflow.
     
  • Contacting your carriers to determine how they will want the 'crossover' week handled.

We also wanted to mention that the new ICD-10 functionality is built on a "foundation" of the latest version of our software - version 4.1.9. This new version also incorporates a major improvement in how the software handles medication and allows much more flexibility in the billing of that medication. You can read an overview of version 4.1.9 by clicking here.

While there is no cost for this update, there may be costs incurred in updating your operating system and/or hardware to support the new version. Click here to review the requirements for version 4.1.9 to ensure your system is up to date. (Note that we will not be scheduling updates to ICD-10 until your system meets those system requirements.)

For clinics who currently dispense and bill buprenorphine through our system, we will be scheduling training on the process showing enhanced inventory and billing functionality starting in July.

P.S. An ICD-10 Sneak Peek

We will be rolling out a complete set of documentation in the next few weeks but wanted to give you a preview of this new functionality.

 

The core of this new functionality is the "crosswalk" screen which allows the mapping of ICD-9 codes (shown below on the left half of the window) with suitable ICD-10 equivalents (shown on the right).

 

The process is as follows:

  1. First, the user selects an ICD-9 code which doesn't yet have an ICD-10 equivalent.
     
  2. Then, they click on the "Search" button in the lower-right corner of the window.
  3. The search window will appear and the software will automatically use the selected ICD-9 description as the search criteria.
  4. In the search results, the system will indicate which codes are billable (in green) and which are not (red).
     
  5. Once a code is chosen, the user clicks the "Save" button and the mapping is recorded.
     
  6. The process is repeated for each of the codes being used.

Again, the choice of ICD-10 code should be coordinated by both clinical as well as billing staff to ensure an appropriate code is assigned.

As always, we appreciate you being a SMART Partner.

SMART Management Inc.

 

Update #3 - July 9, 2015

Dear valued SMART partners,

During our internal testing phase of the new ICD-10 functionality and in anticipation of the beta release of our software, we wanted you to be aware of the following details:

  • This update incorporates significant changes to the database structure. If you do any in-house reporting that depends on data extraction from the SMART database, you'll want to review those changes to ensure your internal reporting needs remain operational and accurate. Please contact us if you require this information.
     
  • All active patients must have a current diagnosis documented in their EHR. For now that must be coded using ICD-9. Beginning October 1, you'll need to use ICD-10. Ensure that you have each patient diagnosed in the EHR and build a cross-walk between all the ICD-9 diagnoses you currently use and their viable ICD-10 equivalent.
     
  • Here's what we're doing and what you should do and/or continue to do:

    • DSM-5 is coming. States will eventually require the transition from DSM-4. As a proactive measure, begin thinking about shifting to DSM-5 as soon as you can, reserving use of DSM-4 only as needed, if needed.
       
    • We suggest that you rediagnose to the DSM-5 criteria as a normal part of treatment planning until all diagnoses have been updated. The relationship between diagnoses and billing codes is now more complicated so your billing and clinical staffs will need to discuss which billing codes your agency will bill for.
       
    • Most clinicians have been trained using the DSM for diagnosing individuals. Yet HIPAA requires the use of ICD for billing. For DSM-4/ICD-9, the two systems are completely in harmony. For DSM-5/ICD-10, this is not the case. We suggest doing some research to understand the relationship between DSM-5 and ICD-10. http://www.dsm5.org/
       
    • Here are a few articles that can help explain the changes from DSM-4 to DSM-5:

  • We will provide some common equivalents between DSM-5 and ICD-10. Click herefor a PDF of the equivalents. Your agency should review that information for accuracy and appropriateness.
     
  • The software allows for edits/updates to the mapping via the screen below:


     

As of the 15th of July, we will have an online video overview of the new medication functionality in version 4.1.9. Look for a link to the video next week.

 

Thank you for letting us be your EHR software provider. We look forward to helping you through the transition to ICD-10.

 

Update #4 - July 29, 2015

Dear valued SMART partners,

SMART is proud to announce that version 4.1.9.1 of oursoftware which incorporates ICD-10 functionality has reached beta!

For those who aren't aware, "beta" represents a key milestone in the software development process at which all functionality has been implemented, internal feedback has been incorporated, and the software is ready to be tested by a larger audience under real-world conditions.

 

For those sites with a test server already in place or the ability to create one, we recommend installing this new version on a test server. We will be contacting you to schedule this update.

For those without a testing server or are cloud-based, we will notify you when the beta testing process is complete and the software is available for general distribution.

As part of the update process, we ask that you confirm your own readiness in terms of system requirements. In addition, we are requesting that you confirm with your payers that they are ready and able to accept ICD-10 codes. While most of the larger carriers are ready, some smaller ones may still be in the testing phase of the process. Now would be an ideal time to do that. We ask that you confirm your readiness for the update and notify us of that information through our support portal, or via email to Support@smartmgmt.com, Ann-Marie or Kathy. Release notes for this version will be posted in the next day or two and available on our portal at support.smartmgmt.com.

The new ICD-10 functionality is being added to an already robust update to our software - Version 4.1.9.0 - which introduced a major change in the way the application handles medication. It is now possible for clinics to configure new medications and add additional attributes to existing ones. It also adds flexible billing options for those medications.

We've posted a quick overview of the enhanced medication management functionality in version 4.1.9 of our software. Click here to view the video

Release notes and training guides for version 4.1.9 are available on our support portal.

As a reminder, it's critical that your hardware and software are up to date in order to accommodate this update. Click here to review the requirements to ensure your system is up to date. (Note that we will not be scheduling updates to ICD-10 until your system meets those system requirements.)

Please familiarize yourself with these new features and let us know if you require any additional training.

Speaking of training, we will be offering weekly training sessions throughout the month of August. We will send out a separate email with days and times; be sure to RSVP so we can plan accordingly. (Note that these are not clinic-specific and are meant to be a broad overview of the new functionality.)

 Version 4.1.9 Overview Video

 

Update #5 - August 11, 2015

Dear valued SMART partners,

As previously mentioned, ICD-10 functionality is in beta in preparation for release.

We ask those of you with version 4.1.9.1 on your test servers to send us your feedback on issues prior to Monday, August 17th. This will allow us to investigate potential issues and make any changes necessary with plenty of time before release.

We are already beginning to schedule updates to production servers and will be reaching out to each of you to confirm a few details prior to the update. This information includes:

  • System and infrastructure readiness
     
  • A partner contact name and cell phone number to be available during the update process
     

As part of the update, we will be performing the following:

  • Installing Java version 8 on your server
     
  • Clearing any old data stored in S2KData
     
  • Migrating any files or folders that do not belong on S2kdata to the backups folder
     

 

You, as the partner, should be taking the following steps:

  • Move any existing applications, which require a different version of Java to a different server. (Due to potential conflicts between different versions of Java and configuration issues, SMART will only allow Java 8 to be installed on the database and/or application server.)

  • Verify that you have met the new system requirements for version 4.1.9.
     
  • Remove any needed files/folders from the S2KDatabase prior to the update.
     
  • Provide an IT resource contact and cell number to be available during the process.
     

We also recommend further familiarizing yourselves with DSM-5 functionality. Some resources on the web are listed here:

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